Gao X, Yang HI, Trinh H, et al. - For cirrhotic patients with lower hepatitis B virus DNA levels, researchers analyzed the impact of antiviral therapy on incidence of hepatocellular carcinoma. Participants in the study were consecutive cirrhosis patients from a US cohort (n = 381) and 408 patients from a Taiwan cohort and they were categorized into low (< 20 IU/ml) and high hepatitis B virus DNA groups (≥ 20 IU/ml), which were then broken into treated and untreated subgroups. Baseline features were comparable for both hepatitis B virus DNA groups, with the exception of hepatitis B e antigen. Cumulative hepatocellular carcinoma incidence between the treated and untreated groups showed no statistically significant difference or cirrhotic patients with hepatitis B virus DNA <20 IU/ml. Antiviral therapy independently predicts a lower risk of hepatocellular carcinoma in patients with hepatitis B virus DNA ≥ 20 IU/ml after adjusting for age, gender, and hepatitis B e antigen status. In chronic hepatitis B patients with cirrhosis and hepatitis B virus DNA of at least 20 IU/ml, antiviral therapy was linked to a 57% lower incidence of hepatocellular carcinoma. Regardless of hepatitis B virus DNA levels and treatment status, though, the incidence of hepatocellular carcinoma is still substantial, highlighting the need for ongoing hepatocellular carcinoma surveillance for all patients with cirrhotic hepatitis B virus .